Tuesday, June 17, 2014

Why Isn't Healthcare Anybody's Pet Project?

The California Legislature are busying congratulating themselves this week on passing a budget on time. Apparently the ability to perform one's job in a timely manner deserves high praise up there in Sacramento. The $156 billion budget was approved relatively painlessly because of record amounts of revenue being collected by the state. This is due to a combination of tax increases passed on the top 1% two years ago, an expanding economy, and a booming stock market centered around white hot Silicon Valley.

There is a little bit of something to fulfill every Democratic representative's campaign promise. Free preschool will be available for all low income families in the state. Public education will see a ten percent increase in their budgets. Felons convicted of drug crimes can now receive food stamps and welfare payments. And the biggest pet project that was saved by this budget? That would be Gov. Jerry Brown's white elephant otherwise known as the high speed rail project or bullet train to nowhere.

This train has been in the planning stages for years after it was sold to voters in 2008 as a cost effective means of transportation between San Francisco and Los Angeles and a source of thousands of construction jobs. The initial estimate placed the price tag at $33 billion. Since then the cost has ballooned to anywhere from $68 billion to $99 billion without one piece of dirt being turned over for construction. The train's initial route has also been downsized. If and when it begins, the bullet train will run between the Central Valley towns of Fresno and Bakersfield, not exactly places millions of people are clamoring to reach. Though now opposed by a majority of Californians, the state legislators shuffled some dubious new found money from the state's cap and trade pollution program to fund hundreds of millions of dollars towards furthering the program's existence. Gov. Brown is expected to sign the budget expeditiously.

Who are the biggest losers in this budget? The state's healthcare system of course. California cut MediCal reimbursements to doctors by ten percent a few years ago during the depths of the economic and budget crisis. Since then it has refused to bring it back to its previous level, which isn't even close to accounting for medical inflation. In the meantime, the state has opened its doors for over one million more people to enroll in the state health program thanks to Obamacare. But does the governor care if all these newly insured patients can't find any doctors willing to see them at the rates paid by the state, which is only about half Medicare's rates and one of the lowest in the nation? Apparently not since he is thrilled with the new budget. Sick patients are the doctors' and hospitals' problems, not his.

In the end, healthcare for the people becomes a tool to help politicians get reelected. Though opening up Medicare to the masses makes great headlines, less is mentioned about how access has been restricted due to poor reimbursements or narrowed physician networks. Let's not even mention that California's new prosperity is owed in part on TEMPORARY tax increases that are set to expire in five years. The legislature is too busy making ongoing fiscal commitments to every liberal lobby to worry about how this windfall will need to be wound down soon. There are no champions in government for true universal healthcare, only ideas to help incumbents get reelected. And doctors are bearing the brunt of this fiasco.

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